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Query: UMLS:C0001175 (AIDS)
120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Major causes of anaemia in pregnancy in tropical Africa are malaria, iron deficiency, folate deficiency and haemoglobinopathies: now there is added also the acquired immune deficiency syndrome (AIDS). Anaemia is often multifactorial, with the different causes interacting in a vicious cycle of depressed immunity, infection and malnutrition. Anaemia progresses through 3 stages: compensation, with breathlessness on exertion only; decompensation, with breathlessness at rest and haemoglobin (Hb) below about 70 g/litre; cardiac failure, with Hb below about 40 g/litre. Without treatment, over half of the women with haematocrit less than 0.13 and heart failure die. Maternal anaemia, malaria and deficiencies of iron and folate cause intrauterine growth retardation, premature delivery and, when severe, perinatal mortality. Surviving infants have low birthweights, immune deficiency and poor reserves of iron and folate. They have entered already the vicious cycle of infection, malnutrition and impaired immunity. Treatment with blood transfusions is even more hazardous since the advent of AIDS, and should be limited to saving the life of the mother. Treatment of malaria is complex as chloroquine-resistant strains are now common. Prevention remains relatively easy with proguanil and supplements of iron and folic acid and is highly cost-effective in the improvement of maternal and infant health; it is more important than ever as it avoids the unnecessary exposure of women and infants to HIV transmitted through blood transfusion.
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PMID:Tropical obstetrics and gynaecology. 1. Anaemia in pregnancy in tropical Africa. 269 76

A 27-year-old white male homosexual with AIDS presented 19 months after the initial diagnosis with persistent fever, marked dyspnea at rest, and severe substernal pain in the chest. A pericardial friction rub was auscultated, and an effusion was demonstrated echocardiographically. Pericardiocentesis yielded 220 ml of serosanguinous fluid. Special stains of the fluid for microorganisms were negative. A mycobacterial infection was suspected, and therapy with multiple antimycobacterial agents was initiated. Cultures of the fluid eventually yielded MAI. Despite therapy, cardiac function declined, and the patient died two months after presentation. Autopsy confirmed the diagnosis of chronic pericarditis due to MAI. Pericarditis due to MAI should be included in the differential diagnosis of cardiac dysfunction in patients with AIDS.
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PMID:Fatal pericarditis due to Mycobacterium avium-intracellulare in acquired immunodeficiency syndrome. 272 Dec 79

Multiple microscopic colonies of encapsulated budding yeasts morphologically consistent with Cryptococcus sp were found in the maternal (intervillous) space of the placenta from a woman with AIDS. The patient contracted acquired immunodeficiency syndrome from her affected husband, who had died of the disease 3 years previously. The woman, who was in her sixth pregnancy at term, became symptomatic 1 month before delivery with malaise, oral thrush, and cervical lymphadenopathy. Tests for human immunodeficiency virus and serum hepatitis were negative. Cryptococcus neoformans was cultured in the blood and herpes simplex virus type II was isolated from the cervix. On the second postpartum day, the patient had difficulty breathing and died suddenly. Post-mortem examination disclosed a massive pulmonary embolus and disseminated infection with Cryptococcus organisms.
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PMID:Cryptococcosis of the placenta in a woman with acquired immunodeficiency syndrome. 277 45

To determine the prevalence of cardiac abnormalities in patients with human immunodeficiency virus (HIV) infection, two-dimensional Doppler echocardiography was performed on 70 consecutive patients with HIV infection, including 51 with acquired immunodeficiency syndrome (AIDS), 13 with AIDS-related complex and 6 with asymptomatic HIV infection. Of the 70 patients, 36% were hospitalized and 64% were ambulatory at the time of evaluation. The average age was 37 years; 93% were homosexual men. Echocardiographic findings included dilated cardiomyopathy in eight patients (11%), pericardial effusions in seven patients (10%) (one with impending tamponade), pleural effusion in four patients (6%) and mediastinal mass in one patient (1%). Among the 25 hospitalized patients, echocardiographic abnormalities were noted in 16 (64%), whereas among the 45 ambulatory patients, the only abnormality noted was mitral valve prolapse in 3 patients (7%) (p less than 0.0001). Dilated cardiomyopathy was the only echocardiographic lesion more common in the 25 hospitalized patients than in 20 hospitalized control patients with acute leukemia. Symptoms of congestive heart failure responded to conventional therapy. Cardiac lesions were associated with active Pneumocystis carinii pneumonia and low T helper lymphocyte counts. Dilated cardiomyopathy of unknown origin may be more common than was previously recognized in hospitalized, acutely ill patients with AIDS, but is uncommon in ambulatory patients with HIV infection. Echocardiography should be considered in the evaluation of dyspnea in hospitalized patients with HIV infection, especially those with dyspnea that is out of proportion to the degree of pulmonary disease.
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PMID:Cardiac manifestations of human immunodeficiency virus infection: a two-dimensional echocardiographic study. 292 51

Although many of the pulmonary manifestations of tuberculosis in the acquired immunodeficiency syndrome (AIDS) are well known, endobronchial involvement has not been previously described. We report the clinical, roentgenographic, and bronchoscopic features of three patients with endobronchial tuberculosis and AIDS. All of the patients had nonspecific symptoms of fever and cough; however, none exhibited the classic findings of dyspnea, wheezing, or hemoptysis. Smears of sputum were nondiagnostic. The chest x-ray film revealed mediastinal adenopathy in two patients and a lower lobe consolidation in the third; all had small ipsilateral pleural effusions. Endobronchial lesions were white or pink exophytic masses obstructing the airways, mimicking bronchogenic carcinoma. Areas of "classic" primary tuberculosis were seen in two of the patients. Despite ongoing clinical and roentgenographic deterioration, all patients responded well to antituberculosis medications. Given the frequency of tuberculosis in patients with AIDS and AIDS-related complex, one should maintain a high index of suspicion for involvement of the tracheobronchial tree, so as to avoid a delay in diagnosis and resultant increased morbidity and mortality.
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PMID:Endobronchial tuberculosis in the acquired immunodeficiency syndrome. 319 66

From 1982 to 1987, 22 patients with proven Pneumocystis carinii pneumonia were diagnosed at Wellington Hospital. Patients comprised 15 males and 7 females aged 15-76 years and included seven with AIDS, eight with haematological malignancy and seven with renal disease. Two distinct clinical prodromes occurred. In renal patients a classic fulminating pneumonitis developed over 24 to 72 hours. In patients with AIDS a more indolent illness occurred lasting 3 or more weeks and was characterised by fever, dry cough and breathlessness. Haematology patients showed no specific duration of prodrome. At the time of diagnosis all had an abnormal chest radiograph and the arterial PO2 was reduced in all but one case. An invasive diagnostic procedure was performed in all except one case where the diagnosis was made at post mortem. Two patients required a second procedure to establish the diagnosis. Procedures performed included bronchoalveolar lavage [14], open lung biopsy [7] and transbronchial lung biopsy [2]. All patients were treated with high dose cotrimoxazole and 18 survived to leave hospital. A review of the approach to the diagnosis and treatment of Pneumocystis carinii pneumonia is presented.
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PMID:Management of Pneumocystis carinii pneumonia in the immunocompromised host. 326 Jun 63

We observed 276 HIV-infected patients to determine the frequency, degree, and clinical presentation of the lymphocytic alveolitis in different stages of HIV disease, and also to identify the lymphocyte subsets involved. In 154 patients with proved lung infections or tumors (group A), bronchoalveolar lavage fluid showed lymphocytosis in 78 percent of cases. In 122 subjects (31 AIDS and 91 HIV-infected non-AIDS patients) without evidence of lung tumor or infection (group B), lymphocytic alveolitis was seen in 72 percent of cases. In 61 of 88 (69 percent) group B lymphocytic patients, we observed respiratory symptoms or diffuse interstitial opacities; however, we also observed such alveolitis in 27 of 46 (59 percent) group B patients free of respiratory symptoms and abnormality of chest x-ray film. This alveolitis was seen not only in AIDS or ARC patients but also at earlier stages of HIV infection. T-lymphocyte analysis showed a large majority (40 to 93 percent) of CD8 positive lymphocytes in the 37 patients tested. A dual fluorescence analysis revealed, in 18 subjects, that those cells were phenotypically cytotoxic (CD8 + D44 +). These findings suggest that, regardless of HIV-infection stages and of opportunistic lung infections, a CD8-positive T-lymphocyte alveolitis may be present in HIV-infected patients and could be responsible for cough, dyspnea, interstitial pneumonitis, and abnormalities of pulmonary function tests.
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PMID:Human immunodeficiency virus-related lymphocytic alveolitis. 326 11

To determine the distinguishing features of pulmonary Kaposi's sarcoma (KS) in patients with the acquired immunodeficiency syndrome (AIDS), we compared three groups of patients, 16 with endobronchial KS, 15 with endobronchial KS and an opportunistic lung infection, and 40 with Pneumocystis carinii pneumonia (PCP) without concomitant pulmonary KS. The majority of pulmonary KS patients had extensive cutaneous disease at the time of pulmonary diagnosis, and the diagnosis of pulmonary KS was easily established by the characteristic appearance of the endobronchial lesions. Dyspnea, fever, and cough were common presenting symptoms, but occurred more commonly in association with accompanying opportunistic infection. Diffuse interstitial infiltrates were observed in most patients in both groups, but the findings of nodular parenchymal densities or pleural effusion were more commonly observed in patients with pulmonary KS than in those with PCP alone. Pulmonary uptake of gallium-67 citrate or a diffusing capacity less than 80% were unusual in patients with pulmonary KS alone, but common in those with accompanying opportunistic infection or with PCP alone. Median survival in patients with pulmonary KS was only 2 months, and most patients had complicating opportunistic infections at the time of death. Pulmonary KS is generally a late and often preterminal manifestation of AIDS. Chest radiographs, gallium lung scans, and pulmonary function testing may provide diagnostic information that is helpful in distinguishing pulmonary KS from opportunistic lung infections.
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PMID:Kaposi's sarcoma involving the lung in patients with the acquired immunodeficiency syndrome. 326 51

Cryptococcus neoformans is emerging as an important etiologic agent of disseminated infection in patients with the acquired immunodeficiency syndrome (AIDS). Little attention has been placed on the pulmonary expression of this systemic infection. We report five patients with AIDS and cryptococcosis with primary pulmonary involvement. Patients usually presented with fever, cough, dyspnea, and pleuritic chest pain. Chest x-ray findings varied from localized and diffuse infiltration to lymphadenopathy and pleural effusions. All patients developed disseminated disease despite antifungal therapy. Pulmonary cryptococcosis is a frequent presentation of this infection in patients with AIDS.
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PMID:Pulmonary cryptococcosis in AIDS. 330 48

Thirty-six patients with AIDS and culture-proven nontuberculous mycobacteriosis were compared to 20 patients with acquired immunodeficiency syndrome (AIDS) and tuberculosis with regard to clinical signs, symptoms, and diagnostic methods. Patients with nontuberculous mycobacteriosis were more often younger and homosexuals, while patients with tuberculosis were usually Haitian-American or users of intravenous drugs. A majority of patients with tuberculosis presented with fever and weight loss. These symptoms were seen in approximately 50 percent of the patients with nontuberculous mycobacteriosis. A distinct syndrome of dyspnea, chills, hemoptysis, and chest pain was seen in a significant minority of patients with nontuberculous mycobacteriosis. Lymphadenopathy was seen almost exclusively in patients with tuberculosis. Pulmonary sources (expectorated sputum or bronchoscopy specimens) were the most common source of diagnosis in both groups. Patients in both groups in whom the diagnosis was obtained from pulmonary sources frequently had negative chest x-ray films on presentation. Cavitary disease was absent from both groups.
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PMID:Tuberculosis and nontuberculous mycobacteriosis in patients with AIDS. 334 32


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